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Background: Low-dose computed tomography (LDCT) is gaining attention for its potential to reduce radiation exposure in clinical imaging, particularly for urinary calculi detection. However, the optimal dose and clinical efficacy of LDCT remain to be fully validated. This study aimed to identify the optimal LDCT scanning parameters using an in vitro model, then apply these findings to clinical diagnosis, and assess the efficacy of the optimal dose in detecting urinary calculi. Materials and Methods: Six distinct compositions of human urinary calculi were selected for analysis, with sizes of 1, 2, 4, and 7 mm. Stones of the same composition but different sizes were transplanted into a pork kidney, followed by computed tomography (CT) scans using decreasing doses of 120, 100, 80, 60, and 40 mAs. These scans were used to analyze the presence, size, and location of the transplanted urinary calculi. Subsequently, 150 patients with clinically suspected urinary calculi were scanned using a conventional CT dose of 120 kVp and 250 mAs, as well as the optimal low-dose parameters of 120 kVp and 60 mAs (obtained from in vitro model). Finally, the computed tomography dose index volume (CTDIvol), dose length product (DLP), and effective dose (ED) were recorded for each patient. Results and Discussion: Using the in vitro model scanning, stones of varying compositions were detected with 100% accuracy under the prescribed radiation doses. A total of 150 patients with suspected urinary calculi were included in the analysis. Both conventional-dose computed tomography (CDCT) and LDCT detected a total of 285 urinary calculi. No significant differences in image quality were observed between LDCT and CDCT (p>0.05). However, there was a substantial reduction in the CTDIvol, DLP, and ED by 81%, 79%, and 79%, respectively (p<0.05). Conclusion: LDCT shows promise in clinical practice, offering a significant reduction in radiation exposure without compromising diagnostic accuracy.